Lidocaine infusion: A promising solution for zoster neuralgia in transplant recipients

Intravenous Lidocaine infusion (5 mg/kg) is an effective analgesic treatment for organ transplant patients suffering from zoster-associated neuralgia.

Neurological complications are commonly encountered in solid organ transplant (SOT) recipients. This retrospective case series aimed to determine the safety and efficacy of intravenous Lidocaine infusion in SOT recipients suffering from intractable zoster-associated neuralgia.

SOT recipients diagnosed with herpes zoster or post-herpetic neuralgia (PHN) and numeric rating scale (NRS) pain score of 4 or higher, without satisfactory relief from medications (antidepressants, anticonvulsants, opioids) or interventional procedures (nerve block, radiofrequency, spinal cord stimulation) were recruited.

Each participant received an intravenous infusion of Lidocaine at a dose of 5 mg/kg based on their ideal body weight over a 1.5-hour period. Vital signs were vigilantly watched throughout the procedure. Pain levels, patient satisfaction, side effects, and hepatic and renal function were evaluated at baseline and throughout the follow-up period, which extended to six months post-treatment.

All five volunteers reported significant pain relief and expressed high satisfaction with the treatment outcomes. Pain intensity was notably reduced, and the analgesic effects endured through the six-month follow-up period. Mild side effects were reported by one patient, including brief oral numbness and dizziness. However, no severe adverse reactions or changes in liver and kidney function were observed.

Intravenous Lidocaine infusion proved to be a safe and effective option for managing intractable zoster-associated neuralgia in SOT recipients. It provided sustained pain relief with minimal side effects, offering a potential alternative for patients who do not respond to standard pharmacological therapies.